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偏头痛的发病机制及药物治疗选择状况

Migraine pathogenesis and state of pharmacological treatment options.

作者信息

Sprenger Till, Goadsby Peter J

机构信息

UCSF Headache Group-Department of Neurology, University of California, San Francisco, CA, USA.

出版信息

BMC Med. 2009 Nov 16;7:71. doi: 10.1186/1741-7015-7-71.

Abstract

Migraine is a largely inherited disorder of the brain characterized by a complex, but stereotypical, dysfunction of sensory processing. Often the most obvious clinical symptom is head pain, but non-headache symptoms such as photophobia, phonophobia and nausea are clearly part of the typical presentation. This review discusses the current pathophysiological concepts of migraine and migraine aura, such as a possible brainstem dysfunction and cortical spreading depression. Acute and preventive migraine treatment approaches are briefly covered with a focus on shortcomings of the currently available treatment options. A number of different receptors, such as calcitonin gene-related peptide (CGRP), TRPV1 and glutamate receptors, are currently being targeted by potential novel migraine therapeutics. The prospects of this research are exciting and are likely to improve patient care.

摘要

偏头痛是一种主要由遗传导致的脑部疾病,其特征是感觉处理功能出现复杂但刻板的功能障碍。通常最明显的临床症状是头痛,但诸如畏光、畏声和恶心等非头痛症状显然也是典型症状的一部分。本综述讨论了偏头痛和偏头痛先兆目前的病理生理概念,例如可能存在的脑干功能障碍和皮层扩散性抑制。简要介绍了急性和预防性偏头痛的治疗方法,并重点关注了现有治疗方案的缺点。目前一些潜在的新型偏头痛治疗药物正针对多种不同的受体,如降钙素基因相关肽(CGRP)、瞬时受体电位香草酸亚型1(TRPV1)和谷氨酸受体。这项研究的前景令人兴奋,很可能会改善患者的治疗效果。

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